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Small Quantity Hazardous Waste Generator Inspection Report Date: March 25, 2019 Facility Address: 2006 E Mariposa Rd, Stockton Facility Name: Family Dollar Store #11092 San Joaquin County Environmental Health Department 1868 East Hazelton Avenue, Stockton, California 95205-6232 Telephone: (209) 468-3420 Fax: (209) 468-3433 Web: www.sjgov.org/ehd SUMMARY OF VIOLATIONS (CLASS I, CLASS II, or MINOR - Notice to Comply) RemarksItem # 111 CCR 66262.42(a)(c)(d) Failed to comply with uniform hazardous waste manifest exception requirements. - Manifest number 010788833FLE (12/6/2017) was not found on site. Hazardous waste generators shall retain copies of all manifests for three years or until a copy signed off by the destination facility is received. The signed off copy shall be retained and made readily available for review for three years. If the generator did not receive a copy of the manifest with the handwritten signature of the owner or operator of the facility to which the generator’s waste was submitted within 60 days of the date the waste was accepted by the initial transporter, the generator shall submit a legible copy of the missing manifest, with some indication that the generator has not received confirmation of delivery. This information shall be submitted to: DTSC Report Repository Generator Information Services Section P.O. Box 806 Sacramento, CA 95812-0806 Immediately locate a copy of the missing manifest or prepare and submit the required information to DTSC. Submit to the EHD a copy of the signed off copy of the manifest or a copy of the information submitted to DTSC. - The following manifest numbers were found without a signed off copy from the destination facility: - 010868379FLE (3/28/2018) (IMG 5107) - 012039697FLE (10/2/2018) (IMG 5104) Hazardous waste generators shall retain copies of all manifests signed off by the destination facility on site for three years and have them readily available for review. If the generator did not receive a copy of the manifest with the handwritten signature of the owner or operator of the facility to which the generator’s waste was submitted within 60 days of the date the waste was accepted by the initial transporter, the generator shall submit a legible copy of the missing manifest, with some indication that the generator has not received confirmation of delivery. This information shall be submitted to: DTSC Report Repository Generator Information Services Section P.O. Box 806 Sacramento, CA 95812-0806 Immediately locate a copy of the missing manifests or prepare and submit the required information to DTSC. Submit to the EHD a copy of the signed off copy of the manifests or a copy of the information submitted to DTSC. This is a Class II violation. Page 10 of 18 FA0022690 PR0539984 SC001 03/25/2019 EHD 22-01 Rev. 09/22/16 Small Quantity Hazardous Waste Generator OIR